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0 <br /> SWRCB,January 2002 0 Page 1 of 1 <br /> .SPILL/OVERFILL CONTAINMENT BOXES <br /> Facility Name: Flying J# Date of Testing: 5/5/11 <br /> Facility Address: 15100 Thorton Rd. Lodi,CA 95242 <br /> Facility Contact: Mannager Phone: <br /> Date Local Agency Was Notified of Testing: <br /> Name of Local Agency Inspector(ifpresent during testing): <br /> TESTING CONTRACTOR INFORMATION <br /> Company Name: Jones Covey Group,Inc. <br /> Technician Conducting Test: Robert Vargas <br /> Credentials: ❑ CSLB Licensed Contractor SWRCB Licensed Tank Tester <br /> License Type: License Number: <br /> Facility is Not Equipped With Spill/Overfill Containment Boxes ❑ <br /> Spill/Overfill Containment Boxes are Present,but were Not Tested ❑ <br /> Test Method Developed By: ❑ Spill Bucket Manufacturer ® Industry Standard ❑Professional Engineer <br /> ❑ Other(Specify) <br /> Test Method Used: ❑ Pressure ❑ Vacuum ® Hydrostatic <br /> ❑ Other(Specify) <br /> Test Equipment Used: Incon TS-STS Equipment Resolution: +/-0.0001 <br /> Ir"""Spill Box# T-5/87 Spill Box# Spill Box# Spill Box# <br /> Bucket Diameter: 18" <br /> Bucket Depth: 18" <br /> Wait time between applying <br /> pressure/vacuum/water and 30Min <br /> starting test: <br /> Test Start Time: 5:43 5:59 <br /> Initial Reading(RI): 4.5346 4.5350 <br /> Test End Time: 5:58 6:14 <br /> Final Reading(RF): 4.5350 4.5341 <br /> Test Duration: 30Min(l 5min each) <br /> Change in Reading(RF-RI): 0.0004 0.0001 <br /> Pass/Fail Threshold or 0.0020 <br /> Criteria: <br /> Test Result: ® Pass ❑Fail ❑ Pass ❑Fail ❑ Pass ❑ Fail ❑ Pass ❑Fail <br /> Comments <br /> Technician's Signature: Date:5/5/2011 <br />